Clinical and Experimental Reproductive Medicine

The Korean Society for Reproductive Medicine (대한생식의학회)
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Effect of artificial shrinkage on clinical outcome in fresh blastocyst transfer cycles

  • Received : 2011.04.18
  • Accepted : 2011.06.08
  • Published : 2011.06.30
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Abstract

Objective: This study aimed to determine the safety and clinical effect of artificial shrinkage (AS) in terms of assisted hatching of fresh blastocysts. Also, we evaluated the correlation between patient age and the effect of AS on clinical outcome. Methods: Two AS methods, using a 29-gauge needle and laser pulse, were compared. Seventy-three blastocysts were shrunk using a 29-gauge needle and the same number of other blastocysts were shrunk by a laser pulse. We evaluated the shrunken blastocysts hourly and considered them viable if they re-expanded >70%. Blastocyst transfer cycles (n=134) were divided into two groups: a control group consisted of the cycles whose intact embryos were transferred (n=100), while the AS group consisted of the cycles whose embryos were replaced following AS (n=34). The implantation and pregnancy rates of the control group and AS group were compared ($p$ <0.05). Results: The re-expansion rates of the 29-gauge needle and laser pulse AS groups were similar (56 [76.7%] vs. 62 [84.9%], respectively). All of the remaining shrunken blastocysts were re-expanded within 2 hours. There was no degeneration of shrunken blastocysts. The total and clinical pregnancy rate of the AS group (23 [67.6%]; 20 [58.8%], respectively) was significantly higher than that of the control group (47 [47.0%]; 39 [39.0%], respectively). In the older patient group, there was no difference in the clinical outcomes between the AS and control groups. Conclusion: These results suggest that AS of blastocoele cavity, followed by the transfer, would be a useful approach to improve the clinical outcome in cycles in which fresh blastocyst stage embryos are transferred.

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References

  1. Houghton FD, Humpherson PG, Hawkhead JA, Hall CJ, Leese HJ. $Na^+,\;K^+$, ATPase activity in the human and bovine preimplantation embryo. Dev Biol 2003;263:360-6. https://doi.org/10.1016/j.ydbio.2003.07.014
  2. Biggers JD. Reflections on the culture of the preimplantation embryo. Int J Dev Biol 1998;42:879-84.
  3. Watson AJ, Barcroft LC. Regulation of blastocyst formation. Front Biosci 2001;6:D708-30. https://doi.org/10.2741/Watson
  4. Veeck LL, Zaninovic N. An atlas of human blastocysts. New York: Parthenon Pub. Group; 2003.
  5. Glass RH, Lin TP, Florence J. Mouse blastocyst re-expansion following puncture and treatment with inhibitors. J Reprod Fertil 1973;35:533-6. https://doi.org/10.1530/jrf.0.0350533
  6. Gonzales DS, Bavister BD. Zona pellucida escape by hamster blastocysts in vitro is delayed and morphologically different compared with zona escape in vivo. Biol Reprod 1995;52:470-80. https://doi.org/10.1095/biolreprod52.2.470
  7. Vanderzwalmen P, Bertin G, Debauche C, Standaert V, van Roosendaal E, Vandervorst M, et al. Births after vitrification at morula and blastocyst stages: effect of artificial reduction of the blastocoelic cavity before vitrification. Hum Reprod 2002;17:744-51. https://doi.org/10.1093/humrep/17.3.744
  8. Son WY, Yoon SH, Yoon HJ, Lee SM, Lim JH. Pregnancy outcome following transfer of human blastocysts vitrified on electron microscopy grids after induced collapse of the blastocoele. Hum Reprod 2003;18:137-9. https://doi.org/10.1093/humrep/deg029
  9. Hiraoka K, Kinutani M, Kinutani K. Blastocoele collapse by micropipetting prior to vitrification gives excellent survival and pregnancy outcomes for human day 5 and 6 expanded blastocysts. Hum Reprod 2004;19:2884-8. https://doi.org/10.1093/humrep/deh504
  10. Mukaida T. Artificial shrinkage (AS) of blastocoele prior to cooling step of vitrification improves the survival rate of vitrified human blastocysts. Fertil Steril 2004;82:S115.
  11. Mukaida T, Takahashi K, Goto T, Oka C. Ultra-rapid vitrification using a cryoloop technique for human blastocyst cryopreservation. Fertil Steril 2005;84:S476.
  12. Chen SU, Lee TH, Lien YR, Tsai YY, Chang LJ, Yang YS. Microsuction of blastocoelic fluid before vitrification increased survival and pregnancy of mouse expanded blastocysts, but pretreatment with the cytoskeletal stabilizer did not increase blastocyst survival. Fertil Steril 2005;84 Suppl 2:1156-62. https://doi.org/10.1016/j.fertnstert.2005.03.074
  13. Desai N, Szeptycki J, Scott M, Abdelhafez FF, Goldfarb J. Artificial collapse of blastocysts before vitrification: mechanical vs. laser technique and effect on survival, cell number, and cell death in early and expanded blastocysts. Cell Preserv Technol 2008;6:181-9. https://doi.org/10.1089/cpt.2008.0007
  14. Mukaida T, Oka C, Goto T, Takahashi K. Artificial shrinkage of blastocoeles using either a micro-needle or a laser pulse prior to the cooling steps of vitrification improves survival rate and pregnancy outcome of vitrified human blastocysts. Hum Reprod 2006;21:3246-52. https://doi.org/10.1093/humrep/del285
  15. Alves da Motta EL, Alegretti JR, Baracat EC, Olive D, Serafini PC. High implantation and pregnancy rates with transfer of human blastocysts developed in preimplantation stage one and blastocyst media. Fertil Steril 1998;70:659-63. https://doi.org/10.1016/S0015-0282(98)00263-5
  16. Schwarzler P, Zech H, Auer M, Pfau K, Gobel G, Vanderzwalmen P, et al. Pregnancy outcome after blastocyst transfer as compared to early cleavage stage embryo transfer. Hum Reprod 2004;19:2097-102. https://doi.org/10.1093/humrep/deh398
  17. Fong CY, Bongso A, Ng SC, Kumar J, Trounson A, Ratnam S. Blastocyst transfer after enzymatic treatment of the zona pellucida: improving in-vitro fertilization and understanding implantation. Hum Reprod 1998;13:2926-32. https://doi.org/10.1093/humrep/13.10.2926
  18. Turker M. Relevance of assisted hatching with blastocyst stage transfer. The Embryologists 2000;2:1-15.
  19. Goto S, Kadowaki T, Hashimoto H, Kokeguchi S, Shiotani M. Stimulation of endometrium embryo transfer can improve implantation and pregnancy rates for patients undergoing assisted reproductive technology for the first time with a high-grade blastocyst. Fertil Steril 2009;92:1264-8. https://doi.org/10.1016/j.fertnstert.2008.08.076
  20. Gardner DK, Lane M, Stevens J, Schlenker T, Schoolcraft WB. Blastocyst score affects implantation and pregnancy outcome: towards a single blastocyst transfer. Fertil Steril 2000;73:1155-8. https://doi.org/10.1016/S0015-0282(00)00518-5
  21. Cha JH, Kim HJ, Yoon HJ, Yoon SH, Kang CW, Lim JH. Vitrification of the blastocyst-stage embryos derived from TESE/PESA. Fertil Steril 2007;88:S358.
  22. Kim DJ, Kim HJ, Yoon HJ, Yoon SH, Lee WD, Lim JH. Day 5 blastocyst has higher viability compared to day 6 blastocyst as vitrified: clinical outcome of 1074 cases. Fertil Steril 2008;90:S291.
  23. Lee SY, Jae BS, Lee SY, Son WY, Yoon SH, Lim JH. Optimization of a thawing method for human expanded blastocysts vitrified using EM-Grid after artificial shrinkage. Fertil Steril 2003;80:147-8.
  24. Lee SY, Son WY, Yoon SH, Lim JH. Clinical-pregnancy outcome after vitrification of blastocysts produced from in vitro maturation cycles. Fertil Steril 2007;88:1449-51. https://doi.org/10.1016/j.fertnstert.2007.01.018
  25. Clouston HJ, Herbert M, Fenwick J, Murdoch AP, Wolstenholme J. Cytogenetic analysis of human blastocysts. Prenat Diagn 2002;22:1143-52. https://doi.org/10.1002/pd.502
  26. Blake DA, Forsberg AS, Johansson BR, Wikland M. Laser zona pellucida thinning--an alternative approach to assisted hatching. Hum Reprod 2001;16:1959-64. https://doi.org/10.1093/humrep/16.9.1959
  27. Dokras A, Sargent IL, Ross C, Gardner RL, Barlow DH. Trophectoderm biopsy in human blastocysts. Hum Reprod 1990;5:821-5. https://doi.org/10.1093/oxfordjournals.humrep.a137191
  28. Kokkali G, Vrettou C, Traeger-Synodinos J, Jones GM, Cram DS, Stavrou D, et al. Birth of a healthy infant following trophectoderm biopsy from blastocysts for PGD of beta-thalassaemia major. Hum Reprod 2005;20:1855-9. https://doi.org/10.1093/humrep/deh893
  29. Lyu QF, Wu LQ, Li YP, Pan Q, Liu DE, Xia K, et al. An improved mechanical technique for assisted hatching. Hum Reprod 2005;20:1619-23. https://doi.org/10.1093/humrep/deh809
  30. Fong CY, Bongso A, Sathananthan H, Ho J, Ng SC. Ultrastructural observations of enzymatically treated human blastocysts: zonafree blastocyst transfer and rescue of blastocysts with hatching difficulties. Hum Reprod 2001;16:540-6. https://doi.org/10.1093/humrep/16.3.540
  31. Gardner DK, Schoolcraft WB, Wagley L, Schlenker T, Stevens J, Hesla J. A prospective randomized trial of blastocyst culture and transfer in in-vitro fertilization. Hum Reprod 1998;13:3434-40. https://doi.org/10.1093/humrep/13.12.3434
  32. Matorras R, Matorras F, Mendoza R, Rodriguez M, Remohi J, Rodriguez- Escudero FJ, et al. The implantation of every embryo facilitates the chances of the remaining embryos to implant in an IVF programme: a mathematical model to predict pregnancy and multiple pregnancy rates. Hum Reprod 2005;20:2923-31. https://doi.org/10.1093/humrep/dei129
  33. van Montfoort AP, Fiddelers AA, Janssen JM, Derhaag JG, Dirksen CD, Dunselman GA, et al. In unselected patients, elective single embryo transfer prevents all multiples, but results in significantly lower pregnancy rates compared with double embryo transfer: a randomized controlled trial. Hum Reprod 2006;21:338-43. https://doi.org/10.1093/humrep/dei359

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